Agency Stakeholders - ACAS Online

ATSDR Communication Activities Survey (ACAS)

Documents and Forms

Document Name Document Type
Agency Stakeholders - ACAS Online Form and Instruction
ATSDR Communication Activities Survey AttF2 Online ACAS 20201130.docx Form and Instruction
ATSDR Communication Activities Survey AttF2 Online ACAS 20201130.docx Form and Instruction

Information Collection (IC) Details

IC Title:	Agency Stakeholders - ACAS Online	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	n/a	ATSDR Communication Activities Survey	AttF2 Online ACAS 20201130.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 16	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	16	16
Annual IC Time Burden (Hours)	4	4
Annual IC Cost Burden (Dollars)	150	150

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.